Whether it's a regular cleaning, filling a cavity or performing a root canal, we trust our dental professionals with the care and health of our mouths. But have you ever given much thought to the environment in which dentists and dental hygienists perform their work? How does it stay that sparkling clean? Here's what you need to know about dental infection control.
Instrument and Equipment Cleaning
The Centers for Disease Control and Prevention (CDC) details how dental instruments and equipment should be cleaned and disinfected. Instruments and equipment are classified into one of three categories based on risk of infection transmission: critical, semi-critical and non-critical.
- Critical instruments are used to penetrate soft tissue or bone, and they can also encounter blood. Instruments under this classification include scalers, scalpels, forceps and bone chisels. Critical instruments should be sterilized after each use. Acceptable sterilization methods include autoclaving, dry heat or heat/chemical vapor.
- Semi-critical instruments come into contact with mucous membranes (such as the inside of your cheeks) or non-dry skin. These instruments include mirrors, reusable impression trays and amalgam condensers. They should also be dry heat sterilized after each use.
- Non-critical instruments are those that touch only intact skin. They include blood pressure cuffs, X-ray heads and pulse oximeters. These instruments can be reused between patients after receiving an intermediate-level or low-level disinfection. Intermediate-level is classified as a hospital disinfectant or "tuberculocidal," meaning it kills the bacteria that causes tuberculosis and a host of other bacteria and viruses. A low-level disinfectant is also classified as a hospital disinfectant but is not qualified to kill the same range of pathogens.
Hand washing is extremely important in preventing spreading diseases to patients. According to the CDC, an alcohol-based hand sanitizing solution may be used in all cases except for when hands are covered in visible dirt or debris. A dental professional with visibly soiled hands must wash with soap and water. The CDC recommends performing hand hygiene under these four conditions:
- The dentist's hands are visibly soiled.
- After the dentist uses bare hands to touch equipment that can be contaminated by blood, saliva and other secretions.
- Before and after the treatment of each patient.
- Before putting on gloves and immediately upon glove removal.
Surface Contamination and Office Cleanliness
Cleanliness and infection prevention applies to more than just dental instruments. According to the CDC, a dental office contains two types of surface: clinical contact surfaces and housekeeping surfaces. Clinical contact surfaces include items such as light handles, drawer handles, faucet handles, counter tops, chairs and other items that a patient or dentist would touch during a procedure. Clinical contact surfaces, if not protected with barriers such as clear plastic wrap, bags and sheets, should be cleaned between patients with an EPA-registered hospital disinfectant. Those surfaces should also be cleaned at the conclusion of every workday.
Floors, walls and sinks are examples of housekeeping surfaces. Research indicates they offer little, if any, chance of contamination, and they can be cleaned regularly with detergent and water. Of all housekeeping surfaces, floors should be cleaned the most regularly, says the CDC.
Education and Training
Dental offices should offer ongoing education and training to their employees to make sure policies and procedures are practiced correctly. The CDC recommends that training covers safety guidelines for both employees and patients. Like any business, a dental office must maintain the records of safety and cleanliness training as required by the federal and state governments.
When your tooth hurts or your smile isn't as white as you'd like, you trust your dentist to fix the problem. As long as your dentist maintains certain safety and infection prevention protocols, you can trust them when it comes to dental infection control.